It’s been a hard few months for my grandparents, who lived at the same home for 65+ years. My grandpa (98) was truly in good health up until this spring. He developed aspiration pneumonia and was suddenly hospitalized in March. He never returned home - and after rehab, nursing home and multiple hospital stays, he passed away two weeks ago.
My grandmother (95) was also doing pretty well, considering, and insisted in staying home alone without wearing her emergency call button, despite many family members trying to convince her over and over otherwise. The morning of my grandpa’s funeral, we arrived to her house to pick her up and found her laying on the floor. She had broken her hip just 5 days after my grandpa’s death and required surgery. She’s since been moved from the hospital to rehab where she is absolutely miserable, being very mean to us (her family) and nursing staff, complaining about food/tv/temperature and refusing to even get up and move or try PT.
I really think she may be going through a mental health crisis (which I understand after so much happening in a matter of days), but I’m unsure of how we can help get things moving in the right direction. She heavily relied on my grandpa to take care of everything for 70 years, so she is grieving the loss of him and dealing with a very fresh reality of never returning home to everything she knows and loves. She is sure she’ll be home, even with no effort to get out of bed.
My family does not know what to do. She makes us all feel horrible when we visit everyday (this isn’t necessarily new, she’s been verbally abusive to my mom and aunt for years). We want to help, but also are losing steam as it’s been such a tough few months and everyone’s at their wits end with negative visits.
How can we all stay sane and help her at least try to recover from all this? She seems to want to just give up, but also lays on the “poor me” guilt to literally everyone she talks to - whether she knows them or not. I’m exhausted and at a loss. Bottom line: I could really use some advice on how we can get through this difficult time. Thank you in advance for any help you can provide!
I'm sorry that you lost your grandfather, and that now grandma's life has been turned upside down, but you and I both know that she is exactly where she needs to be right now, and more than likely for the rest of her life. She will adjust. And if she doesn't, well that is on her and not you or your family. There is no way that she will be able to return to her home, especially since it was your grandfather who you say "took care of everything."
Often times when one spouse dies(in couples that have been married a long time)the other one goes shortly after, as they don't want to go on with out each other, so don't be surprised if that is the case with your grandma. I wish you and your family well.
She’s 95, and in a span of very brief time, lost everything that for a very long time, brought structure and security and meaning to her life, AND THEN suffered a catastrophic injury that under the best of circumstances, requires time to improve, and most likely at her age, may NEVER yield a result anything like what she was before she fell??
Would you, a generation or more younger than she, slap a smile on your face and ask a bunch of therapists for a roadmap back to “normal”?
And this is within less than three weeks?
”….lays on the ‘poor me’ guilt…”? No one is ever responsible for ACCEPTING GUILT. Under incredibly trying circumstances, you and your family have NO DOUBT done your very best on her behalf.
You are all in shock from the terrible circumstances that have dropped on you. If it is too difficult for you to visit her, arrange for a therapist to see her. Sometimes VERY DIFFICULT PEOPLE respond much better in dire circumstances to people outside the family. She may be like that.
She also may have suffered as a result of the anesthetic given during her hip surgery. The recovery from such surgery is often horrific.
None of you are responsible for her suffering. If her current conduct is making ANY of you feel worse than you already do, DON’T VISIT.
You are all richly entitled to be comforting one another and thinking ahead to “the new normal”. She is not participating in this thinking and planning, and MAY NEVER DO SO. If you all have done everything possible to get her the best care possible for her situation, YOU HAVE DONE ALL YOU CAN.
There may be some legitimate complaints about the Rehab facility. I know. I broke a hip and spent 30 days in Rehab with neglectful, careless and sometimes mean staff, but PT, OT and other Therapies were the point of being there.
If she does not participate in therapy and "shows no improvement,," she will be dismissed.from Rehab. If she is unable to go home, you will have to finding long term placement care for her.
She needs something to look forward to. Perhaps doing your visits on a regular schedule would help if you can do it. That way, she knows your coming and for how long. Hopefully she begins to look forward to it. If she gets nasty simply tell her you are leaving and will be back the next time to check on her. Make it clear you will leave early if she shows you that she does not want your company. Bring her anything that is a favorite thing/food but don’t stay if she is nasty and take it back if she doesn’t want it.
She will most likely be better off in a facility for everyone involved. She misses her husband and life and you can’t give it back to her. But if her mental state improves or is found to have an underlying medical cause, then you could consider home care with sufficient aide coverage to care for her. She will need to use LTC insurance if she has it or do private pay if she has no LTC but has the financial resources (Medicare will not pay for routine home care or nursing home care except for 90 days immediately after an approved three day hospital stay.) The cost of 24 hour home care is very expensive and out of reach for most people, so unless family members are willing and able to support home care a nursing home is the better option. I try to maintain patience with my 94 and 95 year old parents - just as they did with me. It does not always work. Everybody’s situation is unique.
She is angry
She is frustrated
She may also be mean, nasty and abusive
You can not do anything to change any of those things.
She has to.
Grief takes a while
Her anger could be at herself, at her husband for dying, (and that may make her more angry at herself.)
Her frustration may well be because she can no longer function the way she used to.
You can not do anything to help any of these things.
What you can do is not deal with her when her anger, frustration is heaped upon you.
Go visit. If she begins to treat you in a way that is not acceptable tell her, Grandma, I love you but I can not be treated like that. And leave.
If you call her, the same rules apply. Grandma, I love you but I am not going to be spoken to in that way. And hang up.
If everyone does that it might get the point across but if she has been doing this for 95 years you probably will not change her.
And you might be right about her giving up it is not unusual when a couple have been married that long when one dies the other is not far behind.
It's certainly worth trying... If she can't change her stripes, then all calls and visits will be VERY short. Refusal to participate in PT will also result in a very short stay in rehab! Time to research alternatives for where she will live.
I’m not unsympathetic to the shock she has been through but her daughters have lost their dad and have been through a lot in caring for him and now GM. It’s not easy to care for another 24/7 and when they are critical it’s miserable. Short and light visits and encouragement would be my contribution. Don’t sit around for the drama and complaining. It won’t help her nor anyone else.
Has anyone contacted the social worker at her rehab to discuss how to deal with this situation? Or perhaps a minister to speak with her? I am sure that she is dealing with so many emotions during this time and having an injury only made her time of grief more miserable.
I realize that it is frustrating for the family. I am so sorry that she has always been difficult. This makes it harder for all of you to comfort her. This is why I feel that she may do better with speaking to someone neutral instead of your family. She may be able to open up to them a little easier.
She can’t live alone anymore. She is losing her independence and I am sure that is overwhelming for her as well.
Just try to reassure her that she will be taken care of. Speak to her social worker as soon as you can. They have experience with situations like this and will walk you through the process of her mental and physical health.
Wishing you peace during this difficult time in your lives.
At 95, things can turn from going well, to end of life very fast.
Grandma's recovery is not up to family. It is up to her. Grandma's mind & body + medical treatment + fate.
Her living arrangements will most likely need to change. Likely need round the clock care. If this can't be done in her home (hardly ever is) then somewhere else, likely a full care NH.
But you are well. You do not need to put up with verbal abuse. I presume you have legs to walk you out the door.
Your Grandma can not.
This is how it goes sometimes. Sad. But life. I'd rather be in it, with all the heartache, the pain, the stress then have no life.
Short answer: Call for a psych consult and insist on ongoing psych counseling!
First, realize grandma has suffered 3 "deaths" in a short span. 1 real death of her life partner upon whom she greatly depended; 2 the death of her life as she knew it; and 3 the death of her physical independence.
These rapid fire losses can cause a critical personality to become quiet nasty, and even say and do shocking things that are out of character. Be prepared for worse behavior and know that depression, anxiety, fear and denial are all in play here. I good antidepressant antianxiety med with counseling will definitely put GM on a better track, but it's not an overnight change.
What triggered my opinion is that you said GM was always critical of her daughters. BEEN THERE. My mom was so nasty after her loss of independence when the doctors in rehab told her that she will never be able to live independently again. omygosh, it was the most miserable experience for us. Nothing we did made her happy or satisfied. Docs in ATL GA refused to medicate her because of her age (what's the use attitude). We moved her to TX to live we me and, upon a routine visit to MD Anderson here, she threw me under the bus and made suicidal stmts to the nurse. THEY called psych down immediately and admitted her, to her shock, on suicide watch.
Prior to all this, Mom never see a counselor, only her pastors. Her critical nature signaled that she was really unhappy with herself and her own life - projecting all those thoughts onto others, esp. daughters.
MD Anderson and TX docs didn't hesitate to start my mom on meds. Through meds and ongoing psych counseling, she lost the nastiness, is much less critical (has even started admitting verbally when she's snappy that she's angry with herself, not mad at me. However, I do vocalize and refute the bites with "I'm doing my best." My favorite: "I didn't deserve that." etc.
You guys are going to have to modify your response behavior and actions too. It's like parenting a toddler who is in tantrum mode 24/7. I disagree with others who say GM can't change her ways. She will if you modify your behavior because she will have to if she wants your attention, visits and interaction. Remember though that love must be unconditional and never transactional.
If you've even had a high school semester of psychology, you'll know about Pavlov's dog. Here's what worked for us:
LO gets nasty: stop what you're doing ( as long as they're safe), grab your stuff and leave the room. Don't verbally respond except to say outloud to her, " I'm leaving now. See you tomorrow/later/whatever" Don't say why, just do it.
LO demands immediate attention (for non-safety issues): If not present in the room, Consistently delay responding for 10 minutes! Make her wait. If it's telephone calls or, heaven forbid, a buzzer or bell, answer with a bright voice "What's up, GM?", but delay responding to demands AND use language like 'be there in a minute' 'when I finish what I'm doing' 'i can do that later/tomorrow/next week/whenever'. If you're with her, delay and don't jump to. Always acknowledge with 'just after I finish xzy" then be methodical and caring in your actions.
When you do respond, always make her repeat the request by asking "What's up? What did you need?" with a friendly smile on your face. It's amazing how just smiling activates muscles that make your voice sound lighter.
I'm running out of room, so the next important thing I can say worked what just not responding or taking the bait at all. Sometimes silence is best.
In all, when GM ignores you, continues to demand, becomes abusive or snappy, get up and LEAVE without a word.
Don't respond to guilt. Find a friend to vent to, but don't do a bashing session about GM; that isn't healing for you.
We teach others how to treat us by how we allow them to.
When you do call her on her abusive behavior, use tact, simple language and stay in the specific moment. Sometimes, IMO, it's necessary to let the LO know their behavior is unacceptable (as long as they have cognitive abilities). My Mom doesn't have any dementia issues. She's in full control of her mental status (outside having a UTI or great physical pain), so we're all aware that she knows exactly what she's doing.